Tuesday 29 April 2008

The Health Nightmare

Every time you turn on the TV or open a paper you are greeted with another HSE Nightmare: cancer misdiagnosis, wrong kidney transplanted, needless deaths from stroke, died on waiting list. It's no surprise then that when you look into the HSE archives, that too is like getting trapped in some sort of horrible recurring nightmare. Take the issue of waiting lists from 1998 onwards, through the period when first Cowen, then Martin, then Harney, held the top job in Health. It is like a broken record of broken promises. "Cowen promises more funding for waiting list initiative"(1999) "Minister [Martin] launches new strategy to tackle waiting lists"(2000) "Minister [Martin] announces further £8.9 million allocation of 2001 Waiting List Initiative"(2000)

In fact, Minister Martin promised to end the problem for once and for all. In Feb 2000 he said of waiting lists: "there is no reason to accept them as inevitable. In the current economic climate it is simply not tolerable to people that they should settle for a reduced quality of life as a result of problems of accessibility to fundamental public services".

In the government Health Strategy 2001, signed by both Bertie Ahern and Michael Martin, there is a specific promise on waiting lists. They promise to end the repeating nightmare : "specific targets are set so that, by the end of 2004, no public patient will have to wait for more than three months to commence treatment, following referral from an out-patient department". Wow. We were to wake up from the horrible, sick dreamscape by 2004. Aaaah. But when it came, 2004, Mary Harney was still grappling with waiting lists. In November of that year she was promising more money for the National Treatment Purchase fund in order to tackle waiting lists.

Four years later, in 2008, there were still waiting lists. Harney did make some progress. She said on 5 Feb of this year that "waiting times had come down from years to months". But how many months? The target of three months promised in 2001? Mmmmm. No.

So now, in 2008, 11 years after the first government with Cowen-Harney-Ahern-Martin took office, a stunning 58% of Children and 57% percent of Adults are waiting more than 6 months. That's right, about two thirds of all patients are still waiting for a period twice as long as the target promised seven years ago.

So a despairing population remain locked in the Health Nightmare with no escape. Some people wonder if it's just that the Health Service is chaotic, and suffers from chronic mismanagement? Others wonder if we simply aren't spending enough?

Well the sad news is that it's both of these. The Irish health budget has tripled from 1996 but since it started from a shockingly low base and because the population expanded as well, our per capita investment is still below the Eu average. Clearly in order to make up for decades of underinvestment we needed to overshoot the EU average for a significant and sustained period in order to rebuild the service. That hasn't happened. The recent OECD report tells us that well are still lacking acute beds (by about half) compared to other EU nations.

What about the management and the allocation of resources within the service. Let's begin with the Secretary of the Dept of Health, Michael Scanlon. He recently said about the Irish Health Service that "it is a nightmare trying to find your way through our health system, even when you know your way around it". That's interesting. How about another source : when the commission on public pay tried to assess if the pay scales in HSE management were adequate they were confounded by the impossibility of determining what exactly some of the jobs were supposed to be about. It was unclear what people should be doing or where the chain of accountability lay. No shock there. This shows that nothing has changed since the Brennan Report on the Health Service in 2003 found that:
  • Management and control of services and resources is too fragmented; there is no one person or agency with managerial accountability for how the overall system performs on a day-to-day basis.
  • Those who make decisions (mainly Consultants and other medical practitioners) which commit resources are not accountable for that expenditure and the outputs to be delivered.
  • Systems of governance, financial control, risk management and performance management need to be developed further.
  • The capacity of existing systems to provide relevant, timely and reliable information for linking resources to outputs/outcomes is severely limited.
In short then, we don't invest enough in our health system. Oh, and anyway, the system is hideously inefficient and badly run.

Sadly, nothing will change under Brian Cowen. Any Taoiseach who was serious about the Health crisis would get more involved and would declare it a specific ambition to fix the system. He would team up with the Minister for Health and have regular meetings to help keep the issue at the top of the agenda. But the man who called the Health service Angola will want no hand, act or part in the nightmare. If he changes Harney at all and there is now almost universal appetite for her exit, he will likely plug in another horrified (and probably incompetent) minister who will want to return from Angola ASAP. Back to musical chairs. And regarding investment, well, the man renowned for his caution is hardly going to allow the purse strings to open further on Health. The nightmare goes on..........

Monday 21 April 2008

Lisbon and Tax

[update: while the main post was about tax harmonisation, the comments section has developed into a discussion on the Lisbon Treaty]

What does the Lisbon Treaty say about tax harmonisation? The answer of course is - Nothing. Lisbon will not mean tax harmonisation. (But that won't stop the Euroskeptics from shamefully telling us the lie that Lisbon will mean instant tax levelling and disaster for the Irish economy).

Nevertheless, the issue of tax harmonisation is here to stay. It is here to stay because the huge variation corporate tax rates across the EU is resulting in a massive disparity in Foreign Direct Investment (FDI).

According to the OECD the cumulative FDI Inflows into Europe for the period 1994-2004 look like this:

UK $534m
Germany $375m
France $356m
Spain $184m
Ireland $139m
Italy $100m
Denmark $71m

Ireland getting more than Italy in absolute terms! Unreal. On a per capita level Ireland is getting 5,8 times more FDI than France, 7.5 times more than Germany, and 20 times more than Italy.

A further start figure: according the to US department of State the total US capital stock in Ireland as of 2006 stood at $84billion which is more than double the US investment in India and China put together ($31 Billion).

These stark figures explain a large part of the Celtic Tiger. But they also expose its vulnerability. It is no secret that more and more capital is being diverted to Asia or countries in Eastern Europe such as Estonia which imposes a zero rate of corporate tax on some categories of company.

The figures also explain why some of the bigger European countries are crying foul. The European project was supposed to entail levelling the economic playing field by ironing out distortions in the market across countries. The single market, remember? But Ireland is not the only country seen as an offender. In 2006 Germany accused Austria of fiscal dumping in order to poach companies from Germany. Austria responded that they had to reduce their rates to cope with competition from their neighbours on their Eastern borders.

And so, Germany put the tax debate back on the table.

There is no doubt that it's going to stay on the agenda - although the Germans and French leaders may remain fairly mute about it until after the Irish referendum.

In any case, the referendum will make no difference - Europe, and therefore Ireland, is going to have to face this issue sooner or later. It is true that even under Lisbon each member will retain a veto over taxation, but in practice when the big EU powers apply pressure something has to give. It is unlikely that tax rates will be harmonised, but the way in which tax amounts are calculated could be harmonised to take into account the size of the local market for each firm, or the size of the workforce. This could mean an end to the famous transfer pricing, whereby companies located in a low tax country such as Ireland, simply push their funds around internally to be taxed in the low tax location and not their high tax location. In effect, it would be the same thing - Ireland's tax haven status would disappear.

There are two things to note about this. First, the argument made by the big continental powers is probably right: in terms of how tax is calculated it is ridiculous to pay most of your Eu tax in Ireland simply because you employ 200 people in Sandyford. (Ridiculous if you're German, not if you're one of the employees in Sandyford!)

Second, if the UK backs us we have a fair chance of postponing the inevitable. In the end, the UK will be powerful enough to protect her interests by only agreeing to watered down proposals which will probably be phased in over a long period. It just might be enough to give us enough breathing space to do what we need to do anyway: start unloading some of those eggs into another basket.

Wednesday 16 April 2008

Missing You

She would spend most of the day alone, sitting in the kitchen-living room of her council-built rural cottage. She sat to the right of the fire, facing the window that looked out on the hill where gorse and rush had long conquered the meadow in front of Toland's old house which had melted away among a handful of firs. She would regrip the rosary beads when her mind returned to prayer after wandering among clippings of happy memories and fragments of dreams. And, prayer regained, the focus of her gaze would pan down on the empty chair at the other side of the fire.

The figure who was not in the chair was her husband, who was now almost 7 years dead. They were forced to marry - there was no other choice in 1940s Ireland if the unthinkable happened. Society had reserved a special taboo for their case - they were first cousins. In a tiny, close-knit community, a violation of mores such as theirs couldn't be concealed, it had to be endured. Worse followed. He fell ill and was unable to work their small, subsistence farm. The incessant toil in the fields and on the bogs was now added to her burden of carrying, giving birth to, and rearing a family of 10. One of the ten was to die of TB when he was only 6 months.

These days she would think often about the figure not in the chair. He was timid and physically frail. But he was gentle and compassionate. His slight, bony frame moved slowly in the world. He preferred the imagined life to the real, which he kept at a slight distance. His weapon of survival was his humour - a quirky, almost childish humour. All throughout his married life his humour was his shield against her caustic tongue. She could never let a word of his pass without cutting it down. Even in front of visitors he was always humiliated. He was a silly old. Where did he think he was? He was a waste of oil! She had blamed the ghost in the chair for the life of struggle that was etched in her face.

But again today, she reminded herself that her life was not all misery. She loved their children, even if they didn't visit very often now as adults. She remembered the banter and craic of the meitheal after gathering the harvest. The generosity of neighbours. Births and Weddings. The raucous disorder of children playing on the street. She recalled the earthy smell of livestock and their wordless dignity. The hope of progress after a good year. Ramblers singing and how music suspended the drudgery.

Her whole life, everything in it and that flowed from it, all of it was nested in and around this house. And he, the absence from the chair, had always been there, a quiet, tenacious anchor. She looked again at the chair and took a slow, deep breath.

Tuesday 15 April 2008

Caricature Undrawn: China and the West

I cannot draw cartoons. But if I could here is what I'd draw:

A cartoon version of the Chinese Premier, Hu Jintao is in the centre, wearing a mischievous smile, his roguish eye looks out from the page, his face is turned to the right, fixed on a gigantic carrot that dangles before him. In small letters written on the carrot are : WTO Membership, Olympic Games, Respectability. On the left of the page, and behind Hu Jintaos back is a smug, wily diminutive figure who carries in one hand a rod from which the giant carrot dangles, and his other hand he is bringing down a feather on Hu Jintao's back. The creepy sly figure on the left has The West marked in large letters on the front of his t-shirt, and a tiny upside-down logo on the collar runs "Made in China".

Monday 7 April 2008

Memories of Ice

At the tea station today my colleagues and I were chatting about the cold snap and how the winters seem to have changed since we were young.

Some of the coldest winters I remember occurred when I was about 9 or 10. It was the early 80s. One of those winters, I think 1982, was particularly cold. I thought I could check the integrity of my memory by looking up the Met Eireann site, but it seems they haven't got around to putting their historical data on line. First I thought, that's a shame, it would be a fantastic service.

On reflection, that might be wrong. Maybe we lose something in the conversion of a memory, which is rich, and blurred, and pliable, into a mere fact. (One of my pet subjects at the moment is memory and subjectivity of historical experience, personal and non-personal, and I've my eye on a couple of books, but alas, the unread section of my library is getting too big to bear another parcel from Amazon).

I think there is something wonderful about the unreliability of memories. I find a particular magic in revisiting the ice days of 1982. But maybe it wasn't 1982, it could have been 81, or 83, I'd say 84 at the latest. Maybe there wasn't much ice: that might be what the facts say. Perhaps a few days of -2. But in the deep caverns of experience that I have retained from childhood, I have a record of weeks and weeks of unbroken and severe frost. The landscape of those memories contains very little snow, though everything seemed white. The bitter weather had sucked away the colour, leaving everything in shades of gray. But it was as if in doing so, the contrast was hightened - everything became crisp and sharply focused.

I used to spend a lot of time at my Granny's farm as a boy - holidays and weekends - and I recall being there during the Big Freeze. The Cattle were short of water, in winter they depended on a fairly rudimentary suppy that consisted of a few pipes leading from a spring well on the hill, all lay over ground. They were, of course, frozen solid. So uncle Gabriel and I set off to the lake to fetch a few barrels of water. When we reached the lake, the wide, circular surface was a pure white, motionless disk. Even on a calm day the surface would ripple and dance a little, just to let us know that time was passing. Now it was still, like a stopped clock. The shallows and the deeper centre, reflecting and refracting the sky in different ways, had always looked different. Now the entire covering was uniform. The fir trees on the far side of the lake were a frozen white, and the rolling hills around were shades of gray and white. We had just landed in a lunar crater - in a tractor! The lake appeared to be asleep, and its shoreline was part of its serene dreamscape. Nothing moved. No sound. Until we arrived in the David Brown, disturbing the Sea of Tranquility.

Gabriel had taken a pick axe to smash the ice. His first swing barely scratched the surface. He was as impressed as I was, and so he decided to test his threory that the ice was strong enough to support the tractor. He backed the two large wheels out onto the ice. (he wasn't insane, just young, he was still a teenager) The ice held. Luckily the frosty surface provided enough grip to allow the tractor to pull forward again off the ice. A few hard smashes of the thinner end of the axe eventually smashed the ice. I was kind of surprised, and even disappointed to see the water bobbing under the two or three big chunks of ice that had shattered off. Water underneath after all, not a new era of solid lakes and visible breath. We filled the barrels, icy bucket after icy bucket, then headed for home.
My memory of the frozen lake is stored near dreams that were filed as memories. They must be dreams : one of them has uncle Liam, Gabriel's brother, and who had a reputation for being a pioneer (or just heedless), standing on the ice near the shore. In the background his Ford Capri is parked towards the centre of the lake. There is no motion -- it's, I suppose literally, a freeze frame. And there's a sense of foreboding, the whites aren't white enough, and there is a grave expression on Liam's face, as if whatever was going to happen had already happened.

I hope those memories, or inventions, or dreams, never thaw for they are marvellous and beautiful in all their childish, icy madness.

Friday 4 April 2008

Ahern's Legacy as Taoiseach

I have never been a fan of Bertie Ahern as Taoiseach, but I became, rather reluctantly, a great admirer his political skills. I don't believe he was corrupt in the rotten sense, but he failed to acknowledge the damage that political shananagans have wrought on Ireland and their inherent danger to democracy. He never grasped fully the arrival of the internet age of informed citizen-voters who expect from office holders the oxygen that democracy needs - transparency. And as such, Ahern had at times no little contempt for the machinery of democracy itself, such as the oireachtas, procedure and accountability, and dare I say it, the media.

He was the perfect man for the North. He carries no ideological baggage, even though he comes from a light green republican background, or not so light if you recall that his father fought in the War of Independence and was a supporter of the Old IRA who fought to bring down the Treaty. Bertie is shrewd and pragmatic. He has an acute political instinct. He was able to read the north and tread lightly on its delicate egg shells. He approached it with a genuine desire to achieve peace, not some pre-imagined political outcome that would please the greener wing of Fianna Fáil. And he didn't prejudge the other political actors, British, Unionist or Republican. He treated every man or woman as an equal. And he had honed his deal making skills in partnership talks. On top of all, he was a decent, likeable man. The result was stunning and the photo of his handshake with Ian Paisely is one of the most memorable images of any Irish Taoiseach. For all of this alone, Ahern's legacy is safe.

Ahern had extraordinary success in building a solid, modern political party from the ruin of two decades of infighting. The party had lost its way, and he put them back on track. The same ability to coax a consenus was magnificent there too. He united a fragmented party, and his personal, ordinary manish appeal made him popular with the nation at large. He drank pints, not Chateau Margaux; he was a lover of Man U, not a conaisseur of Rembrant; he lived in a semi-D, not a manor house.

That his parliamentary party are showing signs of fatique, and even arrogance is a symptom of success. Ahern's achievements for his party, which include 3 election wins in a row, are all the more astonishing for having happened in an era of fragmented interests, and competing loyalities. He leaves behind by far the best organised, most efficiently run, and most successfully modenised political apparatus in Ireland. Fianna Fáil scientifically burrowed into the unconquered corners of PR with STV. They became experts in vote management. They became media savvy, tuning in to the new obsession with, and necessity for, slick PR. Message, grooming, make-up.

Ironically those instincts which seal his place in history made him a poor leader in other ways. Ahern never seemed to take decisions. He would either wait until the decision was affectively taken already, or no decision at all would be taken. He never articulated any vision for Ireland in time to come, never outlined in detail what he wanted for his country in any sphere. There were slogans, peace and prosperity, more to do, but that's as far as it went. Even after 11 years with unprecedented financial resources at his disposal, no significant project is marked with Ahern's fingerprint: not in Health, not in education, not in transport. Ahern simply doesn't do vision. And in his wake our key public services lie creaking under the strain of antiquity, begging for reform.

In his cabinet too, his instinct was to offend as few as he could. Reshuffles had no meaning. This put a huge question over whether he rewarded talent or just kept people happy. As his grip on power weakened, and after a terrible, though ultimately successful, third campaign for government, Ahern resorted to doling out jobs for all and sundry. He expanded the number of junior ministries and multiplied the chairs and vice chairs of committees. Everyone he'd hoped, would be happy.

Ahern's term in office coincided with an extraordinary recovery in the Irish economy. Not much of this can be attributed to Ahern: the economy had already been set on a path to recovery, the Us and Britain were experiencing unprecedented booms, interest rates were low and energy was cheap. Moreover, much of the low tax strategy can be attributed to the PDs, and certainly not Ahern. The causes of the Celtic Tiger will be debated endlessly, but no matter. In the end, Ahern ultimately presided over a government that got the cardinal point right in matters economic: do no harm. And on top of that, his team done a lot of things right. Some people talk of the Clinton Boom in the Us. Bertie Ahern has at least as good a claim on the boom during his tenure as President Clinton has on the American surge in the 90s.

But Ahern missed or wilfully ignored other changes that were happening in modern democracies. People are no longer happy to hear pronouncements from Ministers or recieve curt replies from government agencies. Citizens are now informed and demanding. They know how things work and they want decisions explained and reasons given. Many government agencies have moved in this direction, in the inevitable tide of modernisation that has washed over democracies in the internet age. But Ahern himself always treated transparency with no little contempt -- his government gutted the Freedom of Information Act. What are all these explanations about, why should he have to answer to the media? He justed wanted to get on with the job, after his own manner. Conventions, such as the manner in which the Dáil is dissolved or new positions announced, were set aside willy nilly. In other words, Bertie governed with his own system, not the one that previous generations have honed. Like many leaders who are given a long run at the helm, Bertie began to treat the whole apparatus of government like his own little fiefdom: to hell with tradition, he would do as he pleases, and it was nobody's business to ask questions.

It is always wrong for senior office holders to take large donations. It is wrong now, it was wrong in the 90s. That everyone was at it, and that it was the culture of the time is a defence, but a weak one. The inherent risk of bribery and the obvious damage which can ensue for democracy has always been known. The McCracken Tribunal didn't invent Ethics. But even if it was acceptable then for a finance minister to receive enormous donations, it is not acceptable now. Ahern straddled two eras - the pre and post Haughey, and in the end those worlds collided. He stated after McCracken and the Haughey affair that office holders should not compromise themselves by taking money. He had done just that and was snared by Mahon. His response was a web of obfuscations and inventions that brought both hilarity and insult to the Irish people. Each new revelation wore another layer off his famous Teflon until eventually his denials looked naked.

In the end he, and undoubtedly his senior colleagues, realised the wisest course was to pass on the baton. And his exit is far more graceful than an ugly, prolonged defiance after the tipping point had been reached.

Wednesday 2 April 2008

Oidhreacht Bhertie: Freagra don Spailpín

Seo freagra beag gearr ar an alt seo a scríobh an Spailpín Fánach ar imeacht Bhertie.

Aontaíom le cuid mhór a scríobhann an Spailpín: nach duine olc é Bertie; gur imir an freasúra calaois nuair a cháin siad é tar éis an toghcháin in áit é a dhéanamh i rith an fheachtais féin; gur iontach é an t-éacht a rinne sé i gcur chun cinn na síochána sa Tuaisceart.

Ach scríobh peann uasal an Spailpín é seo freisin: [nuair a bhí Bertie] ina Thaoiseach bhí an tír níos saibhre ná mar a bhí riamh.

Tá an ráisteas sin fíor, gach aon fhocal de. Go deimhin, bhí Éire ní ba shaibhre nuair a bhí Ahern ina Thaoiseach. Ach ní hionann é sin is a rá gur Ahern féin nó aon rud a rinne sé a ba chúis leis an rath seo. Mar a tharlaíonn sé, is dóigh liom go bhfuil sé deacair lorg Ahern a fheiceáil ar eacnamaíocht na tíre seo ar chorr ar bith.

Islíodh rátaí cánach go mór. Bhí seo ar siúl sula dtáinig Bertie i gcumhact agus ba iad na PDs is mó a raibh sé mar fhealsúnacht acu dearg-ísliú a dhéanamh ar an cháin.

Tá roinnt rudaí seachtranacha freisin a raibh baint acu leis an tíogar: rátaí isle úis san Eoraip, ola ar phraghas íseal, agus borradh mór millteach in eacnamaíocht Mheircéa.

Anuas air sin tá cúiseanna eile taobh thiar den tíogar: an déimeagrafaic a bhí ag baint le hÉirinn sna nóchaidí - go leor den daonra óg, go leor ban nach raibh ag obair ach sásta dul amach ag obair de réir a chéile. Bhíomar ag baint tairbhe as an leathnú mór sa chóras oideachais - borradh ar an líon daoine a chríochnaigh dara léibhéal sna seachtóidí is sa líon daoine a chríochnaigh triú léibhéal sna hochtóidí.

Anois, tá go leor leor rudaí taobh thiar den tíogar, agus tá an lucht eacnamaíochta ag troid faoi go fóíll. Sea, is cinnte go bhfuil an t-uafás cúiseanna taobh thiar de. Fiú amháin an dóigh ar éirigh leis an IDA agus Entreprise Ireland a gceird a fhoghlaim go bhféadfáidís comhlachtaí móra meiriceánacha a mhealladh.

Rud amháin a raibh Ahern páirteach ann: an chomhphairtíocht shóisialta. Arís tá an gaol idir Ahern agus rath na tíre de bharr na comhphairtíochta iontach doiléir. Murach é, an dteipfeadh ar an phróiséas go hiomlán? An féidir bheith cinnte nach mbeadh aontú éigin i gceist? Agus anseo arís tá ceist mhór faoin mhaith a rinne an chomhpháirtíocht de réir mar d'imigh an aimsir. Agus ní bhíonn i gceist ach cuid bheag de cheadatán den GDP gur féidir a rá gur de bharr an phróiséis atá sé.

I dtaca le comhpháirtíocht is cóir a rá freisin go raibh próiséas eile ann, mar atá An Tagarmharcáil (Benchmarking). Is cinnte go neachaigh an próiséas seo thar fóir agus gur chuir sé go mór is go scannalach le costaisí na séirbhíse poiblí. Ní raibh aon chinnteacht ann, nó aon choinníoll go mbeadh na hardaithe móra ag brath go dlúth ar Athleasaithe a bhí (agus atá) ag teastáil go géar. Sa deireadh thiar thall ní dheacaigh an Tagarmharcáil chun leas na tíre.

Mar sin, ní fhéadfainn aontú le mo chara, An Spailpín Fánach, gur cuid d'oidhreacht Bhertie é an tíogar ceilteach. Cosúil le Clinton, agus b'fhéidir Blair, bhí Ahern san áit cheart ag an am cheart ó taobh cúrsaí eacnamaíocht de. Déanfear trácht go deo sna leabhair staire ar an Clinton boom, agus iontu freisin tá seans maith go luífidh Ahern agus an Tíogar Ceilteach san aon abairt amháin. Ach titeann an dearcadh seo ó chéile nuair a amharctar ar na firící le súil ghéar.

Tuesday 1 April 2008

Remembering Meena

When I was a boy I used to stay over at my Granny's small farm every summer. One summer when I was there I paid a visit to my aunty Philomena -- we called her Meena -- who lived nearby with her husband, John. I think it was 1980, making me 7 at the time. It was a glorious day so Meena took me for a walk to Peter's Lough, which was just over the hill. The walk to the lake was delightful - it took us along a quiet back road, where the only stir was the busy hummmmm of the bees, hovering impatiently over the wild flowers in hedgegrows, or the ocassional chirp overhead. The air was sweet with the scent of summer, and as we went, I plucked at the long grasses that hung out into the road to greet us.

As we turned in towards the lake I noticed a huge rock in the middle of a small round field. There were no other rocks around it, just one giant, rounded boulder dominating the little field. "Where did that stone come from?" I wondered. "Fionn McCool threw it from the top of Breesy mountain, and it landed there" Meena explained. I looked towards Breesey and then at the stone. To dispel my doubts she continued "You see that big hole in the side of it - that's the track of his thumb". I was convinved.

Meena lay down by the lake to soak up some rays, while I waded into the shallows. The shore of the lake was sandy like the beach at Murvagh, and lovely and soft on the feet. I remember looking down at the sunlight playing on the water, and feeling the sand swirling over my feet. "Don't go out too far" Meena warned "there's leeches where it gets deep".

"Leeches?" I wondered.

"They're wee boys like worms and they'd go up into your foot".

"And then what?".

"They go up your leg".

"Jesus" I said, stepping back to safety.

Meena loved the sun, she knew it made her look prettier, and she would grow an inch when someone complemented her tan. She was in her late twenties at the time and a consumate socialite. People loved her company and she had an enormous, admiring circle of friends. She was good crack. She was dependable. She was always very kind to her parents and years later, when her own kids came along, she was a devoted mother.

So everyone was shocked when, still only 38, she was taken ill. I recall that my mother said it was the big C. Meena underwent treatment. I remember her visiting us after her mastectomy. My mother hoped that "with God's help that'll be the end of it". But Meena had her doubts "Now Mag, knowing my luck it'll come back". As a teen, I still couldn't grasp the enormity of her ordeal, but even then, I knew it was something terrible. Her phrase was heavy with dread and it burrowed deep into my young mind.

Within a year of her diagnosis Meena lay terminally ill in Sligo General Hospital. The cancer had spread to her lymph nodes and finally to her lungs. She bravely underwent repeated chemo, despite the terrible stress. And she endured great pain while the doctors used giant needles to remove fluid from her lungs. My parents remarked on how she courageously bore her fate, and always kept asking to see her little three year old daughter.

One evening, after the doctors had ruled out any hope, my parents were visiting her. She was in a bad way. While my parents were there the medical staff administered another injection - chemo I think. Her husband John, who had kept a constant vigil by her bedside, had nipped out for a cup of tea. Shortly after the injection, Meena raised her head and asked my father "give me a kiss". My father leant in, and kissed her on the cheek. Then she raised her arm and made a little feeble wave, and said faintly, "Bye bye now". Her head fell back on the pillow and her life drained away. It was as if the angel of death had tapped her on the shoulder and allowed her a few seconds to say goodbye.

Even now, the mystery of how she knew that death was upon her gnaws at the very root of my conception of the world. Seventeen years later, I still feel the intensity of my family's grief. How one day, when I met uncle Pat crying, I knew. And for days, words went out of use.

When I think of Meena I always remember the trip to the lake, and I recall the face of the big stone, and something makes me want to go back, to climb in over the hedge, to kneel at the stone and feel the imprint of Fionn McCool's thumb.